Impact of obesity on the survival of patients with early-stage squamous cell carcinoma of the oral tongue.

Abstract

BACKGROUND: Although obesity increases risk and negatively affects survival for many malignancies, the prognostic implications in squamous cell carcinoma (SCC) of the oral tongue, a disease often associated with prediagnosis weight loss, are unknown. METHODS: Patients with T1-T2 oral tongue SCC underwent curative-intent resection in this single-institution study. All patients underwent nutritional assessment prior to surgery. Body mass index (BMI) was calculated from measured height and weight and categorized as obese (≥ 30 kg/m(2) ), overweight (25-29.9 kg/m(2) ), or normal (18.5-24.9 kg/m(2) ). Clinical outcomes, including disease-specific survival, recurrence-free survival, and overall survival, were compared by BMI group using Cox regression. RESULTS: From 2000 to 2009, 155 patients (90 men, 65 women) of median age 57 years (range, 18-86 years) were included. Baseline characteristics were similar by BMI group. Obesity was significantly associated with adverse disease-specific survival compared with normal weight in univariable (hazard ratio [HR] = 2.65, 95% confidence interval [CI] = 1.07-6.59; P = .04) and multivariable analyses (HR = 5.01; 95% CI = 1.69-14.81; P = .004). A consistent association was seen between obesity and worse recurrence-free survival (HR = 1.87; 95% CI = 0.90-3.88) and between obesity and worse overall survival (HR = 2.03; 95% CI = 0.88-4.65) though without reaching statistical significance (P = .09 and P = .10, respectively) in multivariable analyses. CONCLUSIONS: In this retrospective study, obesity was an adverse independent prognostic variable. This association may not have been previously appreciated due to confounding by multiple factors including prediagnosis weight loss.

Authors

Iyengar, Neil M; Kochhar, Amit; Morris, Patrick; Morris, Luc G; Zhou, Xi K; Ghossein, Ronald A; Pino, Alejandro; Fury, Matthew G; Pfister, David G; Patel, Snehal G; Boyle, Jay O; Hudis, Clifford A; Dannenberg, Andrew J;

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Carcinoma, Squamous Cell/ complications
  • Carcinoma, Squamous Cell/ mortality
  • Carcinoma, Squamous Cell/ pathology
  • Carcinoma, Squamous Cell/ surgery
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms/ complications
  • Head and Neck Neoplasms/ mortality
  • Head and Neck Neoplasms/ pathology
  • Head and Neck Neoplasms/ surgery
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Obesity/ complications
  • Obesity/ mortality
  • Obesity/ pathology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tongue Neoplasms/ complications
  • Tongue Neoplasms/ mortality
  • Tongue Neoplasms/ pathology
  • Tongue Neoplasms/ surgery
  • Young Adult

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